Physician, manage thyself

By Rebecca Knight

In the fast-changing world of modern healthcare, the job of a doctor is more and more like the job of chief executive. The people who run hospitals and physicians’ practices don’t just need to know medicine. They must also be able to balance budgets, motivate a large and diverse staff and make difficult marketing and legal decisions.

“The focus in medical school is to train good doctors, but part of being a good doctor is being a good manager,” says Fawaz Siddiqi, a neurosurgical resident at the London Health Sciences Centre in Canada. “It’s having a core understanding of how to work within the context of an organisation.”

More

IN Business Education

The desire to be a “good manager” is precisely the reason Dr Siddiqi, who aspires one day to run a hospital, decided to go back to school. This past autumn he enrolled in a health-sector MBA programme at the Ivey School of Business at the University of Western Ontario.

“Physicians are very single-minded animals,” he says. “We come from technically driven science backgrounds. This [degree] is providing me with that business knowhow that I otherwise wouldn’t get.”

Dr Siddiqi is not alone. New doctors who plan on launching administrative careers in medicine or working in the field of healthcare policy are increasingly opting to get a specialised MBA along with their MD degree.

“Medical school was tough because it was an endurance test, but business school challenges you to think laterally – all of a sudden there are no right answers,” says Dr Siddiqi, who will finish at Ivey next spring.

Many business schools have launched healthcare-focused MBAs in recent years. Harvard, Wharton, University of Chicago, Kellogg, Dartmouth and Cornell have all introduced joint degree programmes where students receive both an MD and an MBA, typically in five years. Other schools – such as the Coppead Graduate School of Business in Rio de Janeiro, Baylor University’s Hankamer School of Business and Ivey – run specialised MBA programmes in healthcare administration and management.

Ivey’s one-year programme is a “residency MBA”, according to Dr Kellie Leitch, the programme’s co-director. “We target people who are residents, who’ve worked in a hospital or a family practice already, and have dealt with patients so they have some idea of the demands,” she says.

The programme comprises four modules – three of which involve standard management courses taken alongside the rest of the business school class. In the fourth module, students take courses including clinicaltrials, statistics and phar-macoeconomics, managing health-sector politics and environment, and financing private health-sector enterprises. Students at Ivey also do an internship project with a company – such as working on the launch of a new pharmaceutical product or the strategic analysis of a clinical operations plan.

There is only one MD out of the 14 students in the specialised programme – others are PhDs, nurses or other scientists. But Dr Leitch, who has an MBA, says she hopes to enrol more doctors in the future. “I see this as an opportunity to develop new leaders in the Canadian healthcare system to drive change,” she says.

Dr Leitch says the MBA will enable doctors to take on “leadership roles” earlier in their careers. “They will fare much better in the job market,” she says. “They will be targeted and recruited by institutions to have a specific clinical role, but also a leadership role.”

Duke University’s Fuqua School of Business also offers a specialised health management MBA, in addition to a joint medical and business degree programme. The health-sector programme is geared to doctors who are interested in leading a clinical practice as well as students who want to be involved in the health industry, including biotechnology, pharmaceuticals, medical devices and public policy.

“The medical school curriculum is appropriately very crowded with science, but many students perceive that there are a lot of changes happening in the healthcare sector,” says Dr Kevin Schulman, professor of medicine and management at Duke University Medical Center.

“What we’re trying to do is marry medical students with a core general management MBA and help them take a problem – be it how to take something out of the laboratory and bring it to patients, or how to run a safer hospital – and frame their response in a business context.”

The curriculum enhances the general management programme with health-related courses, Dr Schulman says. Required courses include healthcare in the 21st century and the economics and strategy of health-sector management. Students may also takeelectives such as medical device commercialisation, healthcare marketing, and the economics and management of the pharmaceutical industry.

Dr Kelvin Baggett received his medical degree from East Carolina University in 1999 and then completed his residency at Yale-New Haven Medical Center, specialising in internal medicine. He earned his health sector management MBA from Duke in 2006. “I decided to go to business school after I asked myself: what other skills can I amass that will allow me to have influence on the issues that I care most about?” he says.

“You could have the greatest idea, the greatest plan, but at the end of the day you need to have the resources and an understanding of how to allocate those resources.”

Dr Baggett now works for Hospital Corporation of America in Nashville, Tennessee, as a strategic business consultant. He says he plans to go back to practising medicine one day.

“If you have the clinical piece, the finance piece and the strategy piece, it allows you to be a lot more effective,” he says.

According to Duke, graduates of the health-sector MBA often go on to do residencies. Others work in academic settings, or serve as consultants to corporations and other organisations. Dr Schulman – who earned his MD at New York University and his MBA at the Wharton School of Business – says he encourages students to complete residencies and think about the long-term trajectory of their careers.

“Over the long term, our graduates will do a lot better after they complete their residencies,” he says. “On a selfish level, I want people to have careers in medicine. We don’t need a huge number of new financial analysts, but there is a crying need for clinicians with leadership skills.”